Indications for surgery include standard indications for operative repair for either fracture (clavicular shaft or glenoid neck). Additionally, surgical repair can be extended to include patients who may have borderline indications of each individual fracture but who, in the surgeons opinion, would benefit from stabilization due to the multiple nature of the injuries.

Introduction

In general, the clavicular shaft fracture is repaired initially, followed by reassessment of the alignment of the shoulder girdle in general and the glenoid neck fracture in particular.

Occasionally, re-establishing clavicular length and alignment may result in significant improvement in scapular and/or glenoid position such that further intervention is unnecessary. However, usually minimal change is seen and glenoid neck fixation is required.

Positioning

Fixation

Fixation of the clavicle proceeds as described in the clavicle module of the AO surgery reference.

Reassessment of the glenoid neck fracture

Following this, reassessment of the patient occurs with clinical examination and radiographic evaluation. If significant improvement in shoulder asymmetry and alignment of the glenoid neck fracture has occurred, then no further operative intervention is indicated.